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ORL; Journal For Oto-rhino-laryngology... 2022This study aimed to investigate the associations between dental treatments and fungal maxillary sinusitis (FMS).
OBJECTIVES
This study aimed to investigate the associations between dental treatments and fungal maxillary sinusitis (FMS).
METHODS
We retrospectively reviewed medical charts between July 2014 and March 2019. In total, 100 cases of FMS were included in this study. We also recruited 200 patients as a control group in the same period. Therefore, each of the FMS, chronic rhinosinusitis (CRS), and normal sinus groups consisted of 100 patients. We recorded all endodontic treatments (EDTs), tooth extractions, dental implantations, and apical lesions (ALs).
RESULTS
The FMS group had higher incidences of tooth extraction (49% vs. 11%, respectively) and EDT (29% vs. 16%, respectively) compared to the normal sinus group and fewer ALs compared to the CRS group (6% vs. 24%, respectively). There were significant differences between the CRS and normal sinus groups in the extraction rate (53% vs. 11%, respectively) and frequency of ALs (24% vs. 4%, respectively). The dental implantation prevalence rates were similar across all 3 groups.
CONCLUSION
The rates of tooth extraction were significantly higher in the FMS and CRS groups compared to the normal sinus group. In addition, of the 3 conditions, FMS was related to EDT, and CRS was related to ALs.
Topics: Chronic Disease; Humans; Mycoses; Paranasal Sinuses; Retrospective Studies; Rhinitis; Sinusitis
PubMed: 34614490
DOI: 10.1159/000519213 -
Journal of Endodontics Oct 2022The aim of this study was to determine the frequency and risk factors of maxillary sinusitis of endodontic origin (MSEO) on posterior maxillary teeth evaluated using...
INTRODUCTION
The aim of this study was to determine the frequency and risk factors of maxillary sinusitis of endodontic origin (MSEO) on posterior maxillary teeth evaluated using dynamic navigation and a novel filter of cone-beam computed tomographic (CBCT) imaging.
METHODS
CBCT scans of 453 patients (814 teeth) were selected. Data were divided into 4 groups: (1) root canal treatment (RCT), (2) relation of the root apex to the maxillary sinus, (3) apical periodontitis (AP), and (4) maxillary sinus inflammation (no inflammation, periapical osteoperiostitis, periapical mucositis, partial obstruction, or total obstruction). Frequency distribution and cross-tabulation were used for data analysis. The association of maxillary sinus abnormalities with other variables was analyzed using the chi-square test. The significance level was set at 5%, and the association between dependent and independent variables was analyzed using robust Poisson regression models.
RESULTS
MSEO was found in 65.6% of the cases, and the highest frequency rates were in the periapical mucositis (44%) and partial obstruction (15.8%) groups. The rates of risk factors were highest in the cases of RCT (54.9%), AP (34.3%), and the root apex in contact with the maxillary sinus (53.8%). The most frequent sex and age group were female (55.8%) and 41-50 years (30.5%).
CONCLUSIONS
The frequency of MSEO was high and positively associated with RCT, AP, and the root apex's position in contact with the floor of the maxillary sinus. The maxillary sinus filter of the CBCT software provides a clear image of maxillary sinus abnormalities.
Topics: Cone-Beam Computed Tomography; Female; Humans; Male; Maxillary Sinus; Maxillary Sinusitis; Mucositis; Periapical Periodontitis; Risk Factors
PubMed: 35948173
DOI: 10.1016/j.joen.2022.07.011 -
The Cochrane Database of Systematic... Oct 2015Currently, two separate Cochrane reviews, ‘’ and ‘’ describe the effect of antibiotics for acute rhinosinusitis. Although both Cochrane reviews study the same... (Meta-Analysis)
Meta-Analysis Review
Currently, two separate Cochrane reviews, ‘’ and ‘’ describe the effect of antibiotics for acute rhinosinusitis. Although both Cochrane reviews study the same condition, they look at different populations (patients in which the diagnosis was based on clinical signs and symptoms and patients in which the diagnosis was confirmed by imaging). Because of this, the conclusions are different in these Cochrane reviews. This was confusing for clinicians who needed to read both Cochrane reviews to know which conclusions are most applicable to their patients. This review is being withdrawn and will be incorporated into the updated publication of ‘’. This ‘merged’ review will still maintain the relevant distinction between the two populations. However, information on the effectiveness of antibiotics for rhinosinusitis will be published in the ‘merged’ Cochrane review. We will omit the comparison between antibiotics (as published in this Cochrane review) because the choice for certain antibiotics and/or doses differs according to the local antibiotic resistance patterns and therefore this comparison is less relevant. The editorial group responsible for this previously published document have withdrawn it from publication.
Topics: Acute Disease; Adult; Anti-Bacterial Agents; Clinical Trials as Topic; Humans; Maxillary Sinusitis; Randomized Controlled Trials as Topic
PubMed: 26471061
DOI: 10.1002/14651858.CD000243.pub4 -
Current Opinion in Otolaryngology &... Feb 2023To review the various factors associated with the most common cause of maxillary sinus dysfunction; recalcitrant chronic maxillary sinusitis (RCMS). In addition,... (Review)
Review
PURPOSE OF REVIEW
To review the various factors associated with the most common cause of maxillary sinus dysfunction; recalcitrant chronic maxillary sinusitis (RCMS). In addition, available medical and surgical management options are discussed along with various tips and tricks for optimal management.
RECENT FINDINGS
Defects in mucociliary clearance, immunodeficiency, anatomic factors, and infectious etiologies have been implicated in dysfunction of the maxillary sinus leading to RCMS. Medical management including oral antibiotics or topical drugs have shown varying degrees of success. Endoscopic modified medial maxillectomy (EMMM) has been shown to significantly improve symptoms in patients with RCMS.
SUMMARY
A dysfunctional maxillary sinus presents a clinical challenge. A thorough evaluation of any potential contributing factors must be done in addition to an assessment of the adequacy of prior surgical treatment of the maxillary sinus. Beyond the middle meatal antrostomy, EMMM can be used to effectively address RCMS. In cases that fail EMMM, removal of the condemned mucosa to encourage auto-obliteration of the sinus can be considered.
Topics: Humans; Maxillary Sinus; Endoscopy; Maxillary Sinusitis; Chronic Disease; Anti-Bacterial Agents
PubMed: 36484283
DOI: 10.1097/MOO.0000000000000860 -
The Annals of Otology, Rhinology, and... Oct 2022To investigate the use of near-infrared (NIR) imaging as a tool for outpatient clinicians to quickly and accurately assess for maxillary sinusitis and to characterize...
OBJECTIVE
To investigate the use of near-infrared (NIR) imaging as a tool for outpatient clinicians to quickly and accurately assess for maxillary sinusitis and to characterize its accuracy compared to computerized tomography (CT) scan.
METHODS
In a prospective investigational study, NIR and CT images from 65 patients who presented to a tertiary care rhinology clinic were compared to determine the sensitivity and specificity of NIR as an imaging modality.
RESULTS
The sensitivity and specificity of NIR imaging in distinguishing normal versus maxillary sinus disease was found to be 90% and 84%, normal versus mild maxillary sinus disease to be 76% and 91%, and mild versus severe maxillary sinus disease to be 96% and 81%, respectively. The average pixel intensity was also calculated and compared to the modified Lund-Mackay scores from CT scans to assess the ability of NIR imaging to stratify the severity of maxillary sinus disease. Average pixel intensity over a region of interest was significantly different ( < .001) between normal, mild, and severe disease, as well as when comparing normal versus mild ( < .001, 95% CI 42.22-105.39), normal versus severe ( < .001, 95% CI 119.43-174.14), and mild versus severe ( < .001, 95% CI 41.39-104.56) maxillary sinus disease.
CONCLUSION
Based on this data, NIR shows promise as a tool for identifying patients with potential maxillary sinus disease as well as providing information on severity of disease that may guide administration of appropriate treatments.
Topics: Humans; Hyperplasia; Maxillary Sinus; Maxillary Sinusitis; Prospective Studies; Sensitivity and Specificity; Sinusitis; Tomography, X-Ray Computed
PubMed: 34823368
DOI: 10.1177/00034894211060623 -
American Journal of Rhinology & Allergy Jul 2022Implantological procedures aimed at rehabilitating upper jaw edentulous patients (dental implant placement and/or maxillary sinus grafting) can sporadically result in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Implantological procedures aimed at rehabilitating upper jaw edentulous patients (dental implant placement and/or maxillary sinus grafting) can sporadically result in sinusitis. In these patients, endoscopic sinus surgery is the most commonly employed treatment, but clinical scenarios and comprehensive management strategies are extremely heterogeneous across studies.
OBJECTIVE
We sought to systematically define treatment strategies and related success rates for sinusitis following dental implantation, detailing different current treatment choices and concepts.
METHODS
Adopting a PRISMA-compliant review framework, systematic searches were performed in multiple databases using criteria designed to include all studies published until November 2020 focusing on the treatment of human sinusitis following dental implantation. We selected all original studies, excluding case reports, specifying treatment modalities with objective treatment success definitions. Following duplicate removal, abstract and full-text selection, and quality assessment, we reviewed eligible articles for treatment modalities and success rates, which were pooled in a random-effects meta-analysis.
RESULTS
Among 581 unique citations, eight studies (181 patients) were selected. Seven studies were retrospective case series. All studies relied on endoscopic sinus surgery, often coupled with intraoral accesses, and assessed therapeutic success endoscopically. The pooled treatment success rate was 94.7% (95% confidence interval, 91.5%-98%). Failures were treated in seven of 15 cases with further antibiotic therapies and in another seven cases with surgical revision. A single patient was lost to follow-up.
CONCLUSIONS
Endoscopic sinus surgery appears to be the most frequent treatment of choice for sinusitis following dental implantation, with excellent success rates. The protean clinical picture drawn from the selected studies calls for the standardization of diagnostics and definitions in this field to enable direct comparisons between the results of different studies. The role of postoperative antibiotic therapies, which have been employed unevenly across studies, should also be prospectively investigated.
Topics: Humans; Retrospective Studies; Sinusitis; Maxillary Sinus; Endoscopy; Anti-Bacterial Agents; Dental Implantation; Maxillary Sinusitis; Dental Implants
PubMed: 35244478
DOI: 10.1177/19458924221084484 -
International Journal of General... 2020The role of the accessory maxillary ostium, a common anatomical variant, in the development of chronic sinusitis remains unclear. This study aimed to examine the...
INTRODUCTION
The role of the accessory maxillary ostium, a common anatomical variant, in the development of chronic sinusitis remains unclear. This study aimed to examine the association between chronic sinusitis and presence of an accessory maxillary ostium using computed tomography (CT) of the paranasal sinuses.
METHODS
We conducted a retrospective study of 1188 paranasal sinus CT scans performed in a major tertiary medical center between January 1, 2016 and December 31, 2016. Axial and coronal and views were reviewed to evaluate the presence of accessory maxillary ostia and maxillary and ethmoid sinusitis.
RESULTS
Nine hundred twenty-eight patients were included for analysis. A 52.8% were male. Mean patient age was 33.8 years. A right accessory maxillary ostium was detected in 274 patients (29.5%), which was the same number of patients with a left accessory maxillary ostium. Bilateral accessory maxillary ostia were found in 172. The presence of right maxillary sinusitis was significantly associated with male gender and the presence of a right accessory maxillary ostium. Male gender was the only factor significantly associated with the presence of left sinusitis. Left or right ethmoidal sinusitis was significantly associated with male gender and the presence of left or right maxillary sinusitis, respectively.
CONCLUSION
The presence of an accessory maxillary ostium may contribute to the development of maxillary and ethmoidal sinusitis. Further studies are needed to elucidate this association and determine indications for incorporating the natural and accessory ostia when performing middle meatus antrostomy during endoscopic sinus surgery.
PubMed: 32440195
DOI: 10.2147/IJGM.S253569 -
International Journal of Paleopathology Mar 2024This study reviews the palaeopathological literature discussing maxillary sinusitis to examine current trends and issues within the study of this condition, and to make... (Review)
Review
OBJECTIVE
This study reviews the palaeopathological literature discussing maxillary sinusitis to examine current trends and issues within the study of this condition, and to make recommendations for future research in this area.
MATERIALS
Seventy-five studies were identified through a literature search of digital and physical sources.
METHODS
Information regarding study metadata, the populations investigated, sinusitis diagnostic criteria, and sinusitis prevalence was examined.
RESULTS
Populations from the UK and Europe were the most studied, reflecting both palaeopathology's systemic colonialism and academic legacies. Most studies used diagnostic criteria published in the mid-1990s, with some subsequent studies modifying these criteria.
CONCLUSIONS
The diagnostic criteria from 1995 are widely used but do not include all possible bone changes seen within sinusitis. There is also a need for researchers to engage in issues of data reductionism when using descriptive categories for archaeological sites and populations.
SIGNIFICANCE
This paper provides considerations as to how the 1995 diagnostic criteria may be revised by future researchers and synthesises much of the published sinusitis prevalence data to assist researchers interested in the palaeopathology of respiratory disease.
LIMITATIONS
More general osteological research, which includes palaeopathological information, was likely missed from this review due to the choice of key terms and languages used in the literature search.
SUGGESTIONS FOR FURTHER RESEARCH
Additional research into sinusitis in archaeological populations outside of Western Europe is required. Further work examining the ability to compare pathological data from macroscopic observation and medical imaging would be advantageous to palaeopathology as a whole.
Topics: Humans; Maxillary Sinusitis; Sinusitis; Tomography, X-Ray Computed; Chronic Disease; Prevalence
PubMed: 38147742
DOI: 10.1016/j.ijpp.2023.11.005 -
HNO Aug 2020Until the 1990s, radical sinus surgery was considered a standard procedure for maxillary sinus diseases, but it is no longer favored due to the high morbidity. Today,... (Review)
Review
Until the 1990s, radical sinus surgery was considered a standard procedure for maxillary sinus diseases, but it is no longer favored due to the high morbidity. Today, functional endoscopic sinus surgery (FESS) is considered the gold standard in sinus surgery. Modifications of surgical approaches also allow access to regions of the maxillary sinus that were previously difficult to reach. Depending on anatomy and pathology, different methods for widening the maxillary ostium can be selected. In type I sinusotomy, the natural ostium is widened dorsally by a maximum of 1 cm. Sinusotomy type II involves widening the natural ostium up to a maximum diameter of 2 cm. In sinusotomy type III, the natural ostium is widened dorsally to the posterior wall of the maxillary sinus and caudally to the base of the inferior turbinate. Beside the prelacrimal approach, more invasive approaches are the medial maxillectomy, in which the dorsal part of the inferior turbinate and the adjacent medial wall of the maxillary sinus is resected, as well as its modifications "mega antrostomy" and "extended maxillary antrostomy." Correct selection of the size of the maxillary sinus window is prerequisite for successful treatment and long-term postoperative success. Isolated purulent maxillary sinusitis can usually be treated by a type I sinusotomy. Sinusotomy type II addresses nasal polyps with involvement of the mucosa of the ostium, recurrent stenosis after previous surgery, chronic maxillary sinusitis due to cystic fibrosis, and purulent maxillary sinusitis with involvement of other adjacent sinuses. Sinusotomy type III is required for choanal polyps with attachment to the floor of the maxillary sinus, for extensive polyposis and fungal sinusitis, and for inverted papilloma. Particularly for (recurrent) disease and extensive interventions in the maxillary sinus, medial maxillectomy or a modification thereof may be required.
Topics: Endoscopy; Humans; Maxillary Sinus; Maxillary Sinusitis; Nasal Polyps; Paranasal Sinus Diseases; Sinusitis
PubMed: 32405682
DOI: 10.1007/s00106-020-00870-9 -
The Journal of Oral Implantology Dec 2022To evaluate the available literature reporting the survival and complication rate of zygomatic implants, assessing factors (such as surgical technique,...
AIM
To evaluate the available literature reporting the survival and complication rate of zygomatic implants, assessing factors (such as surgical technique, surgical/restorative plan, population, study design and characteristics, etc.) associated with these outcomes.
MATERIALS AND METHODS
A comprehensive search was performed in three electronic databases, together with a manual search, to identify clinical studies reporting the survival and/or complication rates following zygomatic implant therapy, to quantify relative rates for both stated outcomes. Results: 101 articles were included: 69 were retrospective in nature, 29 were prospective non-randomized studies and 3 were randomized trials (RCTs). The mean survival rate among retrospective studies was 97.61%, while among prospective non-RCTs and RCTs was 98.53% and 95.92%, respectively. The survival rate was not associated with the surgical technique, nor with the surgical/restorative plan. A trend towards higher survival rate, although not statistically significant (p>0.05), was observed in more recent vs less recent studies. Forty-eight articles reported data on complications related to zygomatic implants, with labial laceration, orbital cavity penetration, hematoma, epistaxis, maxillary sinusitis, infection and oro-antral communication being among the most common adverse event. A lower incidence of maxillary sinusitis was observed for zygomatic implants placed using the extrasinus approach compared to the other surgical approaches (p<0.01). The incidence of maxillary sinusitis and oro-antral communications was found to be less likely in "recent" vs "less recent" studies (p<0.05).
CONCLUSIONS
Zygomatic implant therapy is a reliable treatment option for rehabilitating the severely atrophic maxilla, with high implant survival rate and relatively low complication rate. Several factors were found to be associated with the incidence of post-operative complications. Nevertheless, the evidence from the literature is mainly based on non-RCTs and therefore these findings have to be interpreted with cautions.
PubMed: 36473176
DOI: 10.1563/aaid-joi-D-22-00008